Exploring Utilization of Early Infant Human Immunodeficiency Virus-Diagnostic Services at a District Hospital in Rural South Western Uganda. (; Patients’ and Health Workers’ Experiences)

Abstract

Introduction: Early Infant Diagnosis (EID) among HIV Exposed Infants (HEIs) is tailored to improve the management of these infants. The use of Deoxyribonucleic Acid Polymerase Chain Reaction (DNA PCR) has been utilized in the diagnosis of these infants worldwide with the aim of reducing morbidity and mortality to improve the quality of life of these infants. This study aimed to determine the utilization of Early Infant Diagnosis using Deoxyribonucleic Acid Polymerase Chain Reaction tests (DNA PCR). Methods: This was a mixed-method study employing both qualitative and quantitative methods that involved 164 purposively selected caregivers of HIV Exposed Infants enrolled in the Early Infant Diagnosis program 18-45 years and health workers (HWs). Quantitative data was exported and analyzed using Statistical Package for the Social Sciences (SPSS) software for descriptive statistics. Qualitative data was analyzed using inductive thematic content analysis to generate themes of barriers and facilitators of utilization of Early Infant HIV diagnostic services. Data was presented in verbatim form as quotes generated from recoded transcripts. Results: Eighty-one percent (133/164) of the caretakers reported having utilized Early Infant Diagnostic services at Rushere Hospital. This was due to health education by the health workers and follow-up of missed appointments. Awareness of the proper frequency and scheduling of tests in the Early Infant Diagnosis program was quite low with 15/164 participants (9.1%) knowing correct testing schedule intervals. There were poor completion rates with 46.3% of the respondents having completed all the 3 Polymerase Chain Reaction Tests, 12.8 % had done 2 Polymerase Chain Reaction tests and 23.7% had done 1 out of the 3 required Polymerase Chain Reaction tests. The drivers to the utilization of Early Infant Diagnosis obtained from focus group discussions were good knowledge and attitude of health care providers, availability of test kits and follow up of missed appointments while the barriers to the service are distance from the health facility, delay at the health facility. Conclusion: There was good utilization of the Early Infant Diagnosis services and low completion rates which calls for increased awareness to achieve the intended outcome of zero new HIV infections and improved quality of life for HIV Exposed Infants. Both facility and community based interventions should be employed to increase awareness of availability and utilization of Early Infant Diagnosis services.